Minnesota program
Nursing and paid help at home
Medical Assistance can cover assessed nursing needs and some paid care by a parent at home.
What it is
Medical Assistance can cover assessed nursing needs and some paid care by a parent at home.
Discharge can bring care that goes beyond ordinary parenting. Home nursing and Community First Services and Supports have different assessments and rules. Your child’s actual needs, including overnight care, shape the request.
Who can qualify
- Payment needs eligible Medical Assistance coverage and an assessed service need. Coverage and care assessments can be discussed together. Skilled nursing needs differ from CFSS personal-assistance needs.
- Home care nursing for members age 64 and younger is handled outside the health plans.
- Paid parent care is for qualifying tasks beyond ordinary parenting, under both Community First Services and Supports models.
- Home care nursing needs medical necessity, a nursing plan and authorization for skilled care beyond a brief nursing visit or ordinary personal help. CFSS has a separate assessment for daily-activity dependency or qualifying behavior needs beyond ordinary parenting.
What you get
- Covered nursing and personal support at home through Medical Assistance.
- One parent can receive pay for up to 60 approved personal-support hours in seven days.
What the help includes
- If two parents share paid care, the limit is 80 hours in seven days combined, with 40 for each. These parent limits apply across their minor children, not separately to each child.
- Personal assistance through CFSS is different from skilled nursing. A parent of a minor can sometimes be paid for authorized CFSS work after the assessment, worker and training rules are met; this is not payment for all ordinary parenting. Your social worker can help the lead agency explain who can be the worker and who must act as the representative.
- Respite, equipment and supplies may also be part of the appropriate assessed support plan.
If you decide to apply
- Ask your social worker to coordinate home nursing orders and an assessment with the hospital case manager.
- Describe the tasks, time and overnight care your child needs, and ask which qualify for paid support.
Your hospital case manager and county or tribal lead agency. · Official page ↗
After you ask
- The nursing agency confirms when the reviewer has a complete assessment, service plan and other-insurance information. It also confirms the applicable first-action and final-decision deadlines and whether temporary approval is possible. An administrative deadline does not guarantee a nurse is available.
- For CFSS, the lead agency generally supplies assessment information within 10 business days and authorizes services within 40 calendar days of the assessment. Nursing authorization follows a separate process. Neither approval guarantees immediate staffing.
- The oncologist supplies orders and describes the care needed.
Good to know
Approved hours depend on the assessment. Paid nursing by a licensed parent follows a separate hardship-waiver review from personal support.
Other details
- Because children’s nursing is handled directly by the state, its appeal route differs from a health-plan appeal.
- The state confirms the current hardship-waiver criteria before a licensed parent can be paid to nurse their own child. CFSS worker, training and representative requirements are separate.
Official sources
“Could an assessment help us arrange nursing or paid parent care at home? What are the benefits and drawbacks, and could you help with the orders and referral?”
Why I’m asking: I want a realistic care plan for home, including the nights.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask for the assessment and say plainly what the nights look like.
Your social worker
The hospital case manager writes the orders and refers to the lead agency.
The care team
The oncologist writes the orders and the description of what the child needs.
- Who decides
- The state contractor decides the nursing hours; the lead agency approves the support plan within thirty days.
- Ask your social worker
- “Can we get home nursing orders written before discharge, and ask the lead agency about paid parent hours under community first services?”
How to apply
First step: Ask the oncology team for home nursing orders before discharge.
- Ask the oncology team for the nursing orders before discharge.
- Ask the lead agency for an assessment and a support plan.
- Ask whether a parent can be paid for qualifying tasks.
Official application / program page ↗
Where it starts: Ask the oncology team for the orders, then ask the lead agency for an assessment.
What to gather
- The nursing orders
- A description of the care needed each day and night
How long: Nursing deadlines depend on the complete request and applicable review. CFSS assessment information is generally due within 10 business days and authorization within 40 calendar days of assessment; neither guarantees staffing.
What a yes looks like
Approved hours and an agency, or an approved support plan naming who is paid.
What a no looks like, and the next move
Ask what hours were approved rather than whether it was approved, and appeal by the date on the notice.
Watch out
- For a child the nursing is run directly by the state, not the health plan, so the appeal route is different.
- A licensed parent nursing their own child needs the separate hardship waiver.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Nursing hours at home, and up to sixty paid hours in seven days for one parent under community first services and supports.
- $60/week — Paid hours in seven days for one parent under community first services
- $80/week — Paid hours in seven days shared between two parents
- $40/week — Paid hours in seven days for each of two parents
Covers: Nursing hours at home · Personal support hours · Paid parent care for qualifying tasks · Support planning through the lead agency
Legal protection: The reviewer confirms whether temporary nursing approval is available and which complete-request deadlines apply.
What it costs the family: None on Medical Assistance.
The eligibility facts, as published
- Coverage
- Medical Assistance
- Level of care
- assessed need for nursing or personal support at home
- Age
- home care nursing for members 64 and younger runs outside the health plans
- Parent hours
- For authorized CFSS care across their minor children: one paid parent up to 60 hours per seven days; two parents up to 40 each and 80 combined, with separate worker/training/representative rules.
The trap: For a member 64 or younger the nursing is run directly by the state rather than through a health plan, which changes who to ring and who to appeal to. A licensed parent wanting to nurse their own child needs the separate hardship waiver, form DHS-4109.
Where I read this
- DHS provider manual — home care nursing — Minnesota Department of Human Services, read September 10, 2026
- DHS — Community First Services and Supports — Minnesota Department of Human Services, read September 10, 2026
- DHS — Child and Teen Checkups — Minnesota Department of Human Services, read September 10, 2026
- DHS — managed care ombudsperson — Minnesota Department of Human Services, read September 10, 2026